前交通动脉动脉瘤112例诊治真实世界数据分析:单中心报告  

Analysis of real-world data of the diagnosis and treatment of 112 anterior communicating artery aneurysm:a single center report

作　　者：唐必英 李钢[2] 刘珍[2] 乔卫东[2] 王辉[2] 刘成业 肖仕和 Tang Biying;Li Gang;Liu Zhen;Qiao Weidong;Wang Hui;Liu Chengye;Xiao Shihe(Hainan Medical University,Haikou,Hainan 571199,China;Department of Neurosurgery,Sanya Central Hospital/Hainan Third People's Hospital,Sanya,Hainan 572000,China)

机构地区：[1]海南医学院,海南海口571199 [2]三亚中心医院,海南省第三人民医院神经外科,海南三亚572000

出　　处：《中国微侵袭神经外科杂志》2024年第4期203-208,共6页Chinese Journal of Minimally Invasive Neurosurgery

基　　金：海南省自然科学基金高层次人才项目(编号:822RC874);海南省卫生健康科技创新联合项目(编号:WSJK2024MS180)。

摘　　要：目的对前交通动脉动脉瘤(anterior communicating artery aneurysm,ACoAA)病例资料进行真实世界数据(real world data,RWD)分析,总结救治经验。方法回顾性分析112例ACoAA病例资料。男69例,女43例,年龄30~80岁、平均(45.00±11.05)岁。发生蛛网膜下腔出血就诊110例,未破裂就诊2例。行开颅夹闭66例,血管内介入治疗46例,其中应用支架辅助栓塞5例。统计病人的人口学资料、基础疾病、个人史、家族史、入院状况及影像学资料、动脉瘤解剖学特征、病人预后等资料。结果依据改良Rankin量表(modified Rankin Scale,mRS)评分:良好(mRS 0~2分)82例,残疾(mRS 3~5分)22例,死亡(mRS 6)8例。RWD将预后不良的相关因素,纳入有序多分类Logistic回归分析,显示年龄与饮酒史是ACoAA术后预后的独立危险因素,病人居住地、高血压病史及不同治疗术式(开颅夹闭和栓塞治疗)不是病人预后的独立危险因素。结论ACoAA确诊后接受积极治疗(开颅夹闭或栓塞治疗),病人术后恢复良好率较高。ACoAA不良预后可能与年龄、饮酒等因素相关。Objective To analyze a real-word date(RWD)analysis of anterior communicating artery aneurysms(ACoAA)cases and summarize treatment experience.Methods The clinical data of 112 patients with ACoAA were analyzed retrospectively.There were 69 males and 43 females.The patients'ages ranged from 30 to 80 years old,with an average age of 45.00±11.05 years.A total of 110 patients presented with subarachnoid hemorrhage(SAH),while 2 with unruptured aneurysms.Treatment methods:66 patients were treated with craniotomy clipping,and 46 were treated with endovascular intervention,including 5 with stent-assisted embolization.The data collected including patients'demographic information,underlying diseases,personal history,family history,admission status,imaging data,anatomical features of aneurysms and patient prognosis.Results According to the modified Rankin Scale(mRS)scores,the prognosis was good(mRS 0-2)in 82 patients,disability(mRS 3-5)occurred in 22,and death(mRS 6)in 8.The RWD analysis of factors related to poor prognosis was included in the ordinal multinomial logistic regression analysis,which revealed that age and alcohol consumption history were independent risk factors for postoperative prognosis of ACoAA,while patient residence,history of hypertension and different treatment methods(craniotomy clipping and embolization therapy)were not independent risk factors for patient prognosis.Conclusions After the diagnosis of ACoAA,patients receiving active treatment(craniotomy clipping or embolization therapy)have a high rate of good postoperative recovery.Poor prognosis of ACoAA may be related to factors such as age and alcohol consumption.

关 键 词：颅内动脉瘤 前交通复合体 真实世界数据 动脉瘤夹闭术 动脉瘤栓塞术 

分 类 号：R651.12[医药卫生—外科学]